Avaliação da efetividade de estratégias não farmacológicas para o alívio da dor de parturientes na fase ativa do período de dilatação no trabalho de parto

This study was aim to evaluate the effectiveness of strategies non pharmacological for the relief of the intensity of the parturient pain in the phase activates of the dilation period in the labor. Is a clinic rehearse of the type therapeutic intervention before and after" with a quantitative approach, accomplished in the Humanized Unit of Childbirth of the Maternity Januário Cicco School of the Federal University of Rio Grande do Norte, in Natal/RN, whit 130 parturient, being 30 in the pre-test of the strategies and 100 in the application of the strategies non pharmacological combined (breathing exercises, muscular relaxation and lombossacral massage) and isolated (shower bath in a normal temperature). We used the visual analogical scale to evaluate the intensity of the pain of the study parturient before and after" to the application of the strategies in the phases of acceleration, maximum inclination and desaceleration in the phase activates of dilation period in the labor. The principal results showed that the majority of the study parturient was between 20 to 30 years old (60%); with incomplete fundamental teaching (85%); family income until 2 minimum wages (74%); 78% had a companion and these, 44% were the own husband. The oxytocin was administered in the parturient during the phase activates of the labor in 81% of the cases and only 15% these women didn´t reciev anything medication. We verified significant relief (ρ=0.000) of intensity of the pain of the study parturient after application of the strategies non pharmacological combined and isolated. We concluded that the strategies non pharmacological combined and isolated were effective in the relief of the pain of the study parturient in the phase activates de labor

Avaliação da terapia comunitária na atenção primária à saúde

A busca por um modelo democrático de saúde despertou a atenção do governo brasileiro para o estabelecimento de prioridades e estratégias, que impulsionaram a implantação do Programa de Saúde da Família (PSF), atualmente denominada Estratégia Saúde da Família (ESF), a fim de aproximar a equipe de saúde da comunidade e, assim, implementar ações de promoção da saúde e de prevenção do adoecimento. Nessa perspectiva a Terapia Comunitária (TC) emerge como uma tecnologia de cuidado voltada à saúde mental na Atenção Básica de Saúde. Desde 2007, a TC vem sendo desenvolvida no município de João Pessoa/PB por profissionais da ESF: enfermeiras, agentes comunitários de saúde, médicos, odontólogos, fisioterapeutas, nutricionistas, psicólogos, entre outros. O estudo teve como objetivos: avaliar a satisfação dos usuários em relação à TC na Atenção Básica no município de João Pessoa/PB; medir o nível de satisfação dos participantes da TC em relação a essa ferramenta do cuidado; identificar elementos importantes para a satisfação em relação à TC por parte dos usuários. Trata-se de um estudo avaliativo, transversal e observacional, realizado no período de maio a agosto de 2009. Utilizou-se como instrumento de coleta de dados a Escala de Avaliação da Satisfação dos Usuários com os Serviços de Saúde Mental Satis-BR, bem como um instrumento de perguntas complementares utilizado pelos terapeutas comunitários. Os resultados revelaram que dos 198 (100%) entrevistados, 105 (53%) verbalizaram satisfação e 93 (47%) muita satisfação nos encontros de TC, o que evidencia que a totalidade da amostra está satisfeita com a terapia. Os elementos importantes que concorreram para a satisfação dos usuários da TC foram: respeito, dignidade, escuta, compreensão, acolhimento, apoio nas necessidades e boas instalações dos locais onde ocorre a terapia. A TC vem fortalecendo o cuidado à saúde mental, por se constituir como uma tecnologia de prevenção e fortalecendo a porta de entrada para a rede de saúde mental e de apoio psicossocial. Conclui-se, portanto, que a TC vem se destacando como instrumento de inclusão da saúde mental na Atenção Básica no atendimento aos usuários do Sistema Único de Saúde

Plano de Desenvolvimento da Escola (PDE): o processo de implantação de uma nova proposta de descentralização em duas escolas da rede municipal de ensino de Natal de 1999 a 2002

The 1988 Constitution was the legal marc to define changes in Brazilian State with major importance to the layout of public politician. In that moment of redefinitions e openness to new ways the redemocratization, participation and decentralization of public school had as their starter the elementary school. This work focus on the manage of FUNDESCOLA, particularly one of its politics called PDE (Educational Development Plan) wich purpose is guarantee a better quality in teaching and spread out democracy throughout its methodology. It was chosen two public schools: Professor Ulisses de Góis and Antonio Campos. The theoretical and methodological orientation is based on the theory of participative democracy developed by authors such as Putnam and Pateman. They says that a cultural background precedes individual participation in society. The collected data (educational legislation, surveys with all sectors of schools and technicians of Natal educational secretary, and relevant documents of de institutions) showed that PDE. Implementation had opposite runnings in the schools studied. In one, as a consequence of bad preparations of its teachers to absorve its methodology, PDE failed. In another way, PDE achieved its goals, especially helping the structure of action plans of the school and the administrative organization making possible several pedagogic activities planned. The work concludes that the main factor the failure or success of PDE relies on the organizational (both political and pedagogical) structure of each school. This discovery implies three important guidelines when comes to formulation of public politicians: a) Constitution of school; b) the local actors who manages the actions; c) the colletive interest in taking part of decisions

Eleições, pesquisas e estratégias de marketing: a campanha eleitoral de Micarla de Sousa em Natal (2008)

From the importance that the political science and the social sciences began to give the electoral programs on TV, were examined in that work academic the effects of research in electoral marketing strategies in Gratuitous Timetable of the Electoral Publicity of the marketing year the candidate Micarla de Sousa (PV) in 2008 for the prefecture of Natal. To analyze the marketing strategies of electoral candidate Micarla de Sousa were used three sources of data: the HGPE on the first part, The interview with the coordinator's marketing campaign of Micarla de Sousa, José Ivan and the quantitative research carried out by the Office IBOPE before and during the period of HGPE. In the analysis of electoral programs, was used the qualitative and quantitative approach, taking as objective to verify whether there was some change in marketing strategy in the candidate Micarla HGPE. So the electoral programs that candidate were transcribed and analyzed and then faced with the results of researches electoral IBOPE carried out in the same period. The interview with the coordinator's marketing campaign the candidate Micarla de Sousa brought relevant information on the construction of public image at the time pre-electoral and electoral. In search of IBOPE, socioeconomic variables were regarded assex, age, education and income. With the collection of this data, there was an intersection of information about the voting intentions of Micarla candidate for mayor of Natal and it was checked how his candidacy has increased or decreased within the surveyed segments and how these oscillations marketing strategies directed at the candidate's HGPE for any specific audience. Also, do not forget that the electoral process is influenced by various factors, because this process is dynamic

Caminho possível para o desenvolvimento do RN: a utopia do Polo Gás Sal

La présente étude sur la modernisation économique qui s est opérée dans le Rio Grande do Norte, constitue un débat concernant les tentatives de faire aboutir un projet de développement industriel fondé sur l exploitation des matières premières locales telles que le sel, le calcaire, les eaux mères et le pétrole, entre les années 70 et 90 du XXe siècle. Elle cherche à montrer, à partir de l observation de l action planifiée de l État national et régional, soutenu par le capital international et par les groupes économiques et politiques locaux, comment on a tenté d implanter, dans des conjonctures économiques distinctes, une industrie d intrants de base moyennant la création de deux pôles de développement : le Pólo Químico Industrial (1974) et le Pólo Gás Sal (1996). Elle est centrée sur l analyse des actions orientées vers la concrétisation de ces pôles, et prendra pour objet les politiques de développement émanant de l État national, en particulier celles qui relevaient du II PND et qui visaient, au cours des années 70, à l implantation d une industrie décentralisée dans la région Nordeste ; les règles fixées par le Plano Nacional de Desestatizações, destinées à promouvoir les privatisations des entreprises publiques brésiliennes, lesquelles ont rendu possible la vente d Alcanorte au groupe industriel commandé par Fragoso Pires, et les politiques définies par l État national et régional, rassemblées sous le titre de « guerre fiscale » afin d attirer des capitaux internationaux susceptibles de rendre viable le Pólo Gás Sal. Il y est démontré que l État a coordonné un ensemble d actions dans les domaines de l infrastructure et des exonérations fiscales et financières, dans le but d accélérer la transition d une économie primaire et exportatrice vers une économie moderne, industrialisée. Et que le concours simultané de forces économiques et sociales particulièrement expressives le capital national et international, les élites locales n a pas suffi pour promouvoir la modernisation industrielle escomptée des secteurs chimique et pétrochimique. Parmi les différentes raisons qui ont contribué à un tel échec, on peut mentionner : l absence d une accumulation interne préalable de capital ; la dépendance de l économie locale par rapport à la technologie et au capital des groupes économiques internationaux ; l inconsistance des stratégies de développement relevant de la politique qui caractérisait la « guerre fiscale », et la fragilité de la représentation politique locale

A política pública de segurança em Mossoró-RN: uma avaliação de processo da implantação da guarda civil (2009-2013)

The subject of public safety is part of the academic and popular discussions, due to several factors that act in society culminating in an increasing criminality. The importance of the evaluation of public policies in this context consists in a possible control tool, monitoring and necessary adjustments to the government to make the necessary changes. Given this reality, it is thought the research problem: how Mossoró (RN) city has implemented his public security policy? In general guideline of the research, we work with the following hypothesis: the own formulation of the National Policy of Public Safety there are elements that hinder the implementation of a public policy of municipal security in Mossoró. The objective of this research is to evaluate the existing security public policy in the city of Mossoró, by the elements that facilitate and/or hamper its implementation, through the actions of municipal government in the activities of the Mossoro Civil Guard (GCM). For this, a review of the implementation process was conducted, specifically its subprocesses of selection, training, and logistical or operational. Was used bibliographical research, documental primary and secondary, and field research, with conducting of interviews. It was found that with a staff of 197 guards, and with five years of creation, the actions developed by this institution refer to an early implementation of the municipal security policy. The guard has the basic pattern selection, part of function relocation and part of public tender. The formation occurs in an introductory way, however, not complete and specific, for the function performance. Its operability is limited by the number of existing effective and by the physical structure that has not matching the demand yet, which touches on the municipal budgetary reality of direct resource intended to safety. It was found the absence of a municipal plan of public security with principles, guidelines and goals that could direct the actions of the guard. It is concluded that despite of the implementation of the GCM Mossoró have not achieved, within the parameters of efficiency, efficacy and effectiveness have played their actions, projects and programs, it could trigger a process of opening for construction of a municipal security policy. As well as break with the paradigm of municipal actions just meant for surveillance of public property, interaction affirmative for the prevention of violence and crime

Reforma administrativa e gestão de políticas sociais em Mossoró: a falácia dos atores institucionais e sociais

The thesis entitled The administrative reform and social political management in Mossoró: the institutional and social staff's falacy. Comprehends a moment of apprehensiveness and analysis in the reestrcturing process of the city, whose process will show the formation of strategies and deployment of its relation with the social political affectiveness. It represents a single moment in the approach of such a kind of experience in the city. The analysis starts from the third mandate of the Mayor Rosalba Ciarlini Rosado, during the quadriennium 2001/2004, for being the time in which the public management got materialized, such as in the operational way of the social politics. For that, we delimitate this study in two distinct moments: the first one refers to the reform elaboration from the creation of the additional law nº 001/2000 GP/PMM: the second one refers to a practical reform from the social and institutional staff's speech. Within that scenary it was seen that the approaching, though partially, the State Reform and, consequently, the master plan of the state apparatus, which were made of theoretical matrices of such a project locally. However, that is a complex experience, that required the use of field and documental research for the proposed investigation and at the same time, prove the guiding hypothesis of it, what means a grouping of areas like: education, healthy, and social development in only one department City Citizenship Department that is able to materialize a new intitutional arrangement, according to the management principles in the public administration at the govern local level, configuring a reform and not just an institutional adequacy. In that context, it got necessary to apprehending the institutional and social actors' falacy as a way to prove or not the presented hypothesis. Among the first staff, we have the mayor's direct leaders and advisors' perception that express the politcal administrative aspects of the reform and, in the second, the perception of the political view of what has changed concerning the management of the social politics

A trajetória dos movimentos socioambientais em Sergipe : personagens, instituições e estratégias de comunicação

The research aimed to study the emergence, role, and the possibilities of environmental movements in Sergipe, running through an analysis of the period between 1983 and 2011. This goal has been guided by the core issue of research, which was to analyze the relationship between the mission, structure and action of environmental organizations in Sergipe. The research arose from the need to map and critically evaluate the environmental movement in Sergipe. The methodological procedures focused on the literature search, survey papers in Sergipe a time gap of 28 years, detailed analysis of nine "movements" and selected in-depth interviews, semi-structured interviews with dozens of social actors involved in the area. In conclusion, we observed that environmentalism in Sergipe, from its inception, was associated with recovery of consciousness regarding the environment, to combat local problems of degradation, and the search for legitimacy of public opinion. Although the environmental movement have been, at times, the attention of mass media, the movement failed to leave the niche and achieve a more representative portion of society. You can still see the deep relationship between the profile of environmental leaders, capital strength and the practical results of the environmental actions and finally, it was observed that the action of the movements has much stronger bond with the relationship of the organization and its main leaders with the other "environmentalist," than with the structure and mission of the institution

Entre o mercado e a construção social: uma análise da experiência da implantação doPRONAF-infraestrutura e PRONAT nos territórios do Mato Grande-RN e sertão do Apodi-RN (1997 - 2010)

Analyzes the development experience in the Territories of Mato Grande and Sertão do Apodi in the state of Rio Grande do Norte, evaluating the actions of the National Program for Strengthening Family Agriculture, specifically the line of infrastructure (PRONAF-INFRA), and the National Program for Sustainable Development of Rural Territories (PRONAT) in these territories. Summarizes the various rural development approaches and takes the theoretical assumptions of territorial development, the concept of constructed territory and market-plan territory, further the cycle model to analyze public policies selected these experiences. Thus, we propose to test the hypothesis that most of the actions implemented would lead to the formation of market-plan territories, in other words, perceived only as a platform for the presentation of projects. The literature and documents, combined with case studies, interviews and direct observation of the meetings of committees, showed that, despite two boards are under the same laws, rules and formal regulations, have clear differences when considering the theory and concepts that were used as reference. The Apodi s territory is closer to a constructed space thus the search for a broader agenda, more autonomous and more appropriate to the reality experienced by local actors. On other hand the Territory of Mato Grande had the characteristics of a market-plan territory more present. As the result, the territory of Sertão do Apodi accesses not only as part of a greater number of policies and funding sources, ensuring a greater and more diverse investment volume than the territory of Mato Grande. Despite these differences, studies have shown that territorial boards surveyed are still far from becoming the main forum for managing the development from conception planning socially constructed. Showed, finally, that territorial development strategy is relevant, but requires a long walk and a deep and continuous learning process to be successfully implemented in rural areas of Northeast Brazil

Universo encantado do cuidado na autopoiese docente: uma viagem epistemológica transdisciplinar

The health transition experienced in Brazilian health care model requires a metamorphosis in human and society, placing new demands on health and education. The Faculty of Science, Culture and Extension of Rio Grande do Norte (Facex), aware of their responsibilities to the Health System, which brings the principle of comprehensiveness as its structural axis, dared to implement a course of nursing in complex thinking and Experiential Pedagogy Humanescente with curriculum inter / transdisciplinary. For deployment of proprosta was not enough to reform thinking of educators, there was a need corporalizar new teaching practices that are aimed at the integral formation of human beings. In this context, emerged the workshop on Human Education autopoietic, self-forming area of the educator, where he developed an Action Research Existential (PA-E) which enabled experience, describe and analyze how the human autopoietic educators could contribute to the practice educational humanescente transdisciplinary curriculum project. Were worked out in meetings, knowledge necessary to practice the transdisciplinary 1st Meeting - learn to create; 2nd Meeting - learn to recognize the laws of nature with emphasis on complexity theory, 3rd Meeting - learn to organize, 4th meeting - namely autoestruturar themselves; 5th Meeting - know how to choose, 6th Meeting - knowing innovate 7th Meeting - namely exchange. Next an autobiographical perspective, we chose the metaphorical possibility to narrate the ways and strategies covered by the author and apprentice in the company of the Little Prince de Saint-Exupery, in search of a sensible pedagogical practice complex, which promotes re-enchant transdisicplinar education. The route involved five methodological connections: a literature review which relate to training for care in undergraduate nursing: the study of learning processes that drive the formation humanopoiética, emphasizing the relationship that involves the complexity and embodiment in the educational process transdisciplinary, highlighting the analysis of what is to learn from the findings of biosciences and recent cognitive theories of Maturana and Varela, the description of the interdisciplinary curriculum of the nursing course of Facex and Training Workshop, Human autopoietic, with emphasis on Experiential Education Humanescente; the report of seven meetings of the Workshops (cocoon), recording the experiences and listening to educators (luminescent butterflies), the final reflections with learning opportunized. Experientiality lived through, the expressions and words, educators say the influence of workshops for their teaching practices, highlighting it as a space for selforganizing, creating, learning and enchantment, and can identify the workshop as a place of transformation necessary for deployment an interdisciplinary curriculum. The knowledge emerging from the study indicate the need for permanent spaces of self, in which the educator learns from its body, between cognitive processes and vital, and in the experiences of their formative process the opportunity to act on the dimensions of knowing and being

Entre telas, diálogos e estratégias: formação docente para a mídia televisiva

Cette recherche à comme but montrer l'importance de la formation des enseignants pour la média télévisive. Réaliser le potentiel des stratégies de formation, comme des éléments essentiels pour faire les enseignants professionnels capables de développer des interventions éducatives pour la lecture critique de la média télévisive. le travail repose sur l'apport conceptuel prévu spécialement par Belloni (2001), Buckingham (2005, 2007), Elias (1998), Fantin (2007), Fischer (2001, 2007), Imbernón (2009), Placco e Souza (2006), Ramalho, Nuñez e Gauthier (2004) e Tardif (2002). Organiser un groupe de discussion avec la participation des enseignants dans les écoles publiques de ville, en ayant des réunions périodiques pour la réalisation de discussions autour de l'arbre de la média télévisive et l'éducation. Le travail emploie des stratégies de formation, en ayant le but de promouvoir le développement de l'enseignement et l'apprentissage des enseignants concernés. Il utilise la méthodologie de recherche-action-formation, en se fondant sur des déclarations de Thiollent (2007) et de Vosgerau (2009). Ce travail applique l'analyse du contenu de Bardin (2009), pour aider à l'organisation des catégories émergées à partir des données recueillies. Il croit à une possible spécificité de la formation des enseignants pour l'utilisation critique de la média télévisive, en considérant le potentiel créatif de l'enseignant, le contexte personnel et de la performance professionnelle, leurs expériences avec les médias de télévision, ainsi que celles des étudiants, et la capacité de réfléchir sur la pratique, et c'est ça la thèse de cette recherche

A implementação do programa Gestão nota 10 no sistema municipal de educação em Mossoró/RN (2005 a 2009)

This research work is focused to show the changes in educational administration from the agreements between the Mossoró / RN and the Ayrton Senna Institute IAS, for education provision. Nowadays, the partnership policy is a constitutive element of the reform of the Brazilian State, which dropped its action on social policies and to strengthen its regulatory role, encouraging private participation in planning, preparation and implementation of public policies, new printing setting the political-social. In this context, the 10 Note Management Programme, developed by the IAS, is part of the neoliberal logic of modernization of public school systems, focusing on results and developing strategies for control and regulation of schools work and its efficiency, effectiveness and greater productivity. The 10 Note focuses on two dimensions: the management of learning and teaching in networking, in a managerial perspective to overcome the culture of failure (expressed as age-grade, dropout and repetition rates in) and implantation of culture of success (as measured in the improvement of the indices). To understanding the process, we have delimited as the object of study, the process of implementing them mentioned program in the city, which its objective is to analyze implications for the school community from the perspective of democratic management, adopting the dimensions of autonomy and participation in institutional processes as a criterion of analysis. From a methodological point of view, the survey was conducted from a literature review and documentary about educational policy developed in the country since the 1990´s, seeking to understand, in a dialectical perspective, the political dimensions of teaching, training and performance of the subjects involved in the school work. Besides the empirical observation, it was also used semi-structured interviews with a methodological tool for gathering information and opinions about the partnership and the implementation of the 10 Note Management Program in the county. The interviewee participants were ex-former education managers, coordinators, school managers, secretaries and teachers. Regarding the dimensions inside the analysis (autonomy and participation), the research led to the conclusion: that GEED, under the guidance of IAS promoted regulation of school autonomy, set up the selection process for exercising the office of school administration and system awards to schools, pupils and teachers, subject to results, there is mismatch between the managerial logic and the democratic management principles, that the ideological discourse of modernization of municipal management coexists with traditional practices, centralizing patronage, which ignores the democratic participation in the school decisions processes, the goals of the partnership were partially achieved, since that the city has improved over the approval and dropouts, although the approval of the Education Municipal Plan of the rules institutional (administrative, financial and educational) and the creation of the Councils observed that the school community participation is still limited, not being characterized as a coordinated intervention, capable of promoting the transformation and improvement its quality in the county. In the same way, the orientation of networking is a limit to the autonomy of schools, given the external definition of goals and strategies to be adopted, along with pressure exerted through the accountability of each school community for their achievements

Beirando a vida, driblando os problemas: estratégias de bem viver

The purpose of this study is to analyze the strategies used by families living in at-risk-and-vulnerable situations registered with the Estratégia Saúde da Família (ESF) ( Family Health Strategy ) as they face their daily problems. This is an investigation of a qualitative nature, using interview as the main tool for an empirical approach. Ten women from the Panatis location in northern Natal, Rio Grande do Norte, whose families live in precarious social-economical situations were interviewed. The interviews occurred between the months of April and June, 2007. The reports revealed that a mixture of improvisations and creativity was used as strategies for overcoming the privations and necessities of daily life. We also reached the conclusion that these families sought solutions for their problems through religiosity and a gift reciprocity system as resources for obtaining personal recognition and support in adversity. The results, in addition, point to ESF as one of the strategies used by these families in the search for attention and care. From this perspective, ESF has proven to be a place for listening and the construction of ties that are consolidated through home visits, organized groups, in parties and outings that are promoted in the community, reestablishing contact and support among people and signaling a way out of abandonment and isolation. Holders of knowledge constructed through life experiences, the participants of the study led us to induce and infer the need to amplify space that will allow them to express meanings, values and experiences, and consider that becoming ill is a process that incorporates dimensions of life that go beyond the physical. As health professionals, we need to be aware of the multiple and creative abilities used in the daily lives of these families, so that we can, along with them, reinvent a new way of dealing with health

Saúde da família: uma estratégia de mudança no processo de produção dos serviços de saúde

The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caicó, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors

Reinternações psiquiátricas no Rio Grande do Norte: implicações e impacto das novas estratégias de atenção à saúde mental

The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital João Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care.